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心肺复苏与2005年通用算法:心肺复苏质量是否有所改善?

Cardiopulmonary resuscitation and the 2005 universal algorithm: has the quality of CPR improved?

作者信息

Roessler Bernhard, Fleischhackl Roman, Losert Heidrun, Wandaller Cosima, Arrich Jasmin, Mittlboeck Martina, Domanovits Hans, Hoerauf Kaus

机构信息

Department of Anesthesia and General Intensive Care, Medical University of Vienna, Vienna, Austria.

出版信息

Wien Klin Wochenschr. 2009;121(1-2):41-6. doi: 10.1007/s00508-008-1105-3.

Abstract

BACKGROUND AND AIM

Chest compressions are crucial in cardiopulmonary resuscitation (CPR), although the optimal number, rate and sequence are unknown. The 2005 CPR guidelines of the European Resuscitation Council (ERC) brought major changes to the basic life support algorithm. One of the major aims of the ERC was to decrease hands-off time in order to improve perfusion of the coronary vessels and the brain. Using a manikin model of basic life support in simulated cardiac arrest, we compared hands-off time and total number of chest compressions according to the guidelines of 2000 and those of 2005.

METHODS

A total of 50 volunteers performed CPR according to the guidelines of 2000 (Group 2000) and 2005 (Group 2005) in a randomized unblinded cross-over study. Volunteers received 10 min of standardized teaching and 10 min of training, including corrective feedback, for each set of guidelines before performing 5 min of basic life support on a manikin. We compared hands-off time as the primary outcome parameter and the total number of chest compressions as the secondary outcome parameter.

RESULTS

Fifty volunteers were enrolled in the study, one individual dropped out after randomization. In Group 2005, hands-off time was significantly lower (mean 107 +/- 19 [SD] s vs. 139 +/- 15 s in Group 2000 (P < 0.0001) and the total number of chest compressions was significantly higher (347 +/- 64 compressions vs. 233 +/- 51 compressions; P < 0.0001).

CONCLUSION

In this manikin setting, both hands-off time and the total number of chest compressions improved with basic life support performed according to the ERC guidelines of 2005.

摘要

背景与目的

胸外按压在心肺复苏(CPR)中至关重要,尽管最佳的按压次数、速率和顺序尚不清楚。欧洲复苏委员会(ERC)2005年的CPR指南给基础生命支持算法带来了重大改变。ERC的主要目标之一是减少按压中断时间,以改善冠状动脉和大脑的灌注。我们使用模拟心脏骤停的基础生命支持人体模型,根据2000年和2005年的指南比较了按压中断时间和胸外按压总数。

方法

在一项随机非盲交叉研究中,共有50名志愿者分别按照2000年指南(2000组)和2005年指南(2005组)进行CPR。志愿者在对人体模型进行5分钟基础生命支持之前,针对每组指南接受10分钟的标准化教学和10分钟的培训,包括纠正反馈。我们将按压中断时间作为主要结局参数进行比较,并将胸外按压总数作为次要结局参数进行比较。

结果

50名志愿者参与了研究,1名个体在随机分组后退出。在2005组中,按压中断时间显著更短(平均107±19[标准差]秒,而2000组为139±15秒;P<0.0001),胸外按压总数显著更高(347±64次按压,而在200组为233±51次按压;P<0.0001)。

结论

在这种人体模型设置中,按照ERC 2005年指南进行基础生命支持时,按压中断时间和胸外按压总数均得到了改善。

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